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Being a Physician Leader in a Challenging
Environment
PE6, February 11, 2019
Bobbie Byrne MD, Chief Information Officer, Advocate Aurora Health
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Bobbie Byrne, MD MBA FAAP
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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Develop key strategies that will make an impact in a VUCA
environment and identify specifically what actions are best used
under what circumstances
Identify the impact of culture and how that should modify your
approach or generate warning signs
Demonstrate how to tackle the "single source of truth" data
question and how to create a path to this goal while still providing
the key information needed to continue to care for patients and
run the business
Discuss compelling patient and physician stories to gain
consensus or cause disruption as needed
Learning Objectives
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Agenda
“Leading” and “Challenging”
A VUCA world
The role of Culture and Data
Sell it with a Story
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Step #1: Identify your Vision
Step #2: Figure out what needs to be done
Step #3: Do it
What to do when you don’t know what to do…Finding the Strategy
What to do when you don’t know how to do it/sell it…VUCA analysis
Leadership
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Start with your True North
“About one time a year, our organization loses a surgical specimen
that requires the patient to return to the Operating Room and be
placed under repeat anesthesia for a repeat biopsy.”
“And it already happened this year to a 28 year old with Lupus
Pleuritis”
Yield: Funding of $30M for an integrated bar coded lab system
True North: Safety and Health Outcomes
When everything is changing, commitment to the vision and
communication of the vision must be solid
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Go to the scene of the crime
Ask open-ended questions
Dig into the details
Scan for outliers or patterns
Get context
Know your own biases
What to do…Finding the Strategy
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Compare a vendor selection circa 2003 to a vendor selection
today
Clear requirements, limited data set and agreed optimal
outcome
Moving requirements, endless data set and difficulty in
gaining consensus on the question, much less the answer
Pull out your Five-year Strategic Technology Plan?
Need a new way to look at this Challenging Environment
How to do it….
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Advanced by US Army War College to explain a post Cold War
world
Volatility
Uncertainty
Complexity
Ambiguity
Provide leadership guidance based on recognizing VUCA
situations
Utility of obtaining additional data
Ability of experts able to predict response
VUCA
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Volatility
Unpredictable swings or unstable situation
Some data is available: Not difficult to understand but not always
of great value
Additional Expertise is valuable
HIT examples:
Cybersecurity breech risk
Internet Service in some geographies
Recommend:
Stockpile additional experts
Build in redundancy
Cultural preparation: Surprises
“Not IF, but WHEN”
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Cause and Effect basically understood but unsure if change will
happen
Data is available
Additional Expertise has minimal value
HIT example:
Competitive organization has just signed with your core
vendor, concern on staff recruitment
Recommend:
Obtain data, create plan
Reconnaissance on competitive salary & benefits
Cultural preparation: Move Quickly
Prepare to pull the trigger immediately if needed
Uncertainty
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Complexity
Many interconnected parts.
One variable changes several others
Data can be available but often overwhelming to evaluate
manually
Additional Expertise is valuable
HIT Example:
Planning for future regulatory requirements
Recommend: Obtain or grow expert opinion
Cultural preparation: Longer explanations
More extensive organization education needed
Creation of talking points, stories, vignettes to illustrate the
inter-related points
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Ambiguity
Don’t know what we don’t know
Cause & Effect unclear
Drivers of success unknown
Data is not really available
Additional Expertise has minimal value
HIT Example:
Digital Patient Apps
Recommend: Experiment, Rapid Iteration
Cultural preparation: Move without perfect information
Embrace the “Fail Fast”
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Review VUCA Cultural impacts
Surprises-Volatility
Move Fast-Uncertainty
Longer Explanations-Complexity
Decide without Information-Ambiguity
Compare with your organization’s culture
Determine the type of challenge that is most problematic to your
culture
Double down on efforts in that area in creation of both stories and
data
Example: Surprises in Data Conversion
Role of Culture
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In search of the Almighty Source of Truth
One hundred percent is probably not reasonable
Most organizations have political third rails
Transparent process and source
Start with report governance rather than data element governance
Identify the areas where you will go to the wall
Executive level visibility
Most important to weave the data into the story
In VUCA situations where data is not helpful in determining action,
it can still be very helpful in selling/telling the story
Example: Ambulatory go-live complexity
Role of Data
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Story tellers
Physicians are often the most influential people in the room-any
room…exam room, operating room, board room.
Intelligent
Highly skilled, highly trained
At the front lines
Accustomed to refining their words for the audience
Take out the medical lingo
Approach from the patient sideeven more than physician side
Refine the storywash--rinse--repeat
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End With Your True North
When everything is changing, commitment to the vision and
communication of the vision must be solid
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Bobbie Byrne, MD MBA FAAP
bobbie.byrne@aah.org
Please complete online session evaluation
Questions